01 Apr 2018
I read a lovely little journal article that I wanted to share. The article was in regards to thrust manipulation versus nonthrust manipulation (i.e. mobilizations) for the treatment of mechanical neck pain.
Pragmatically Applied Cervical and Thoracic Nonthrust Manipulation Versus Thrust Manipulation for Patients With Mechanical Neck Pain: A Multicenter Randomized Clinical Trial. David Griswold, PT, PhD1, Ken Learman, Morey J. Kolber, Bryan O'Halloran, Joshua A. Cleland. J Orthop Sports Phys Ther 2018 48:3, 137-145.
So, this has been a controversial subject for quite some time. It may have started from a physiotherapy vs chiropractic argument, and a bit of a chest pounding to say that one was better than the other. However, many physios with advanced training in manual therapy also do manipulations… so the question now is simply about manipulation versus mobilization.
The study was a randomized clinical trial, and the outcome measures were numerous (The Neck Disability Index, The Patient-Specific Functional Scale, the Numeric Pain-Rating Scale, deep cervical flexion endurance, Global Rating of Change, number of visits and duration of care.)
Patients (103 of them) were randomly assigned to receive one or the other of the two treatments directed at the neck and thoracic spine. Techniques and dosages were selected by the practitioners as they deemed most appropriate and directed at the most symptomatic level.
What did they find? NO DIFFERENCE! The outcomes were equivalent for both patient groups with mechanical neck pain.
So, Why Do You Care?
Well, this is one that comes up because folks don’t understand that mobilizations and manipulations can both fix a sore neck or back. If you know how to mobilize, you don’t need to refer to someone that does manipulations. If you do manipulations, great! (Add in some rehab exercises, modalities, or soft tissue work, and you are now providing comprehensive care.)
And with that... have a great week folks! And keep being awesome!
Tags: Neck pain , spine pain , mechanical spinal pain , mobilization , manipulation , thrust , non-thrust , manual therapy
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